As I helped him keep his balance, my grandfather lifted his leg unsteadily. The stench of urine in the train station stall was overpowering. My grandfather, age 88 and incontinent, had wet himself on the train. I fortunately had packed an extra pair of pants, which I was now struggling to get him into. I remembered that he was not always this helpless. He had been a robust man, solo-hiking the tallest peaks of Japan at age 65, teaching me to play ice hockey at age 77, and even holding out until age 85 before retiring from his profession as a carpenter. The sudden transformation he had made into this declining old man, aged and embarrassed, was astonishing.